Evaluating clinical supervision in community homes and teams serving adults with learning disabilities

Abstract

Evaluating clinical supervision in community homes and teams serving adults with learning disabilities This paper provides a discussion of some of the professional and policy outcomes associated with implementing clinical supervision within a community service for adults with learning disabilities. It is based upon a small qualitative study whose aim was to examine how clinical supervision was operating, its strengths, its weaknesses and where improvements might be made. The study followed the introduction of clinical supervision 9 months earlier for nurses and carers employed in three community homes and one community multiprofessional team. The method consisted of direct observation of individual and group supervision and staff completing critical incident questionnaires, followed by semi-structured, audio-taped interviews with seven registered nurses and four community team members, including a social worker, psychologist and physiotherapist. Outcomes were expressed in two ways: in terms of the benefits of clinical supervision or of its ambivalence. The range of matters brought for discussion, or resolution, in supervision reflected some of the difficulties or dilemmas staff faced working in this area, for example promoting empowerment and assisting clients to make choices, and dealing with clients' challenging and inappropriate behaviours. As for the role of supervisor there was some evidence of nurses expressing apprehension or unpreparedness, also a perceived general concern over the relatively low status of clinical supervision, thought to be due to absence of visible management approval or failure to articulate properly the objective of supervision. A limitation of the study was its small subject sample although considerable data were gathered in each of the units through relatively long-term contact.

Compliance with Dysphagia Recommendations by Carers of Adults with Intellectual Impairment

“…There is evidence that the more severe the symptoms are, the more likely proxies are to comply [13][14][15][16]. In this study 11/13 dependent clients had both oral and pharyngeal dysphagia (Table 1), i.e., more severe dysphagia.…”

“…The questions required a yes/no response and then further comments were invited. The areas included in the questionnaire were based on the information suggested to be relevant by the literature [3,[10][11][12][13][14][15][16][17][18][19][20]22].…”

“…staff training and experience, inclusion in writing of guidelines, support and supervision, pay, promotion, career structure, staff ratios, and environment need to be considered [13,14].…”

The Cultural Realities of Clinical Supervision in an Acute Inpatient Mental Health Setting

“…In addition, preceptoring and mentorship are already established in some inpatient settings and encompass elements of clinical supervision (Malin, 2000). The trust and sharing of knowledge between supervisor and supervisee, whether under the guise of preceptoring or clinical supervision, can facilitate the transition from novice to expert (Severinsson & Borgenhammar, 1997).…”

“…Clinical supervision was originally introduced as a means of support to nurses in the workplace and has since been recognised as a way of providing nurses opportunities for education, learning, and monitoring (Jones, 2003;Malin, 2000;Williamson & Dodds, 1999). Severinsson and Hallberg (1996) use a pedagogical definition of CS whereby a nurse meets with an experienced practitioner in order to reflect on practice and improve clinical care.…”